Limiting the Testing of AST
| Autor: | George S. Cembrowski, Qian Xu, Trefor Higgins |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
chemistry.chemical_classification
medicine.medical_specialty biology business.industry virus diseases General Medicine Limiting Aspartate Aminotransferases Hepatology digestive system Gastroenterology digestive system diseases Surgery fluids and secretions Enzyme chemistry Alanine transaminase Internal medicine polycyclic compounds biology.protein medicine Alanine aminotransferase business Outpatient environment |
| Zdroj: | American Journal of Clinical Pathology. 144:423-426 |
| ISSN: | 1943-7722 0002-9173 |
| DOI: | 10.1309/ajcpo47vawyridhg |
| Popis: | Objectives Annually, millions of pairs of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) tests are ordered. These enzymes are highly correlated, and ALT is far more specific diagnostically than AST. To reduce AST testing, we suggest measuring AST only when ALT exceeds a predetermined limit. Methods We derived the proportions of elevated ASTs that would not be measured based on 15 months of paired inpatient and outpatient ALT and AST data. Results For inpatients, a 35 U/L ALT limit for initiating AST testing would reduce AST testing by 51%, missing only 3% and 7.5% of ASTs exceeding 50 U/L and 35 U/L, respectively. In outpatients, AST testing can be reduced by more than 65%, with fewer missed elevated ASTs (0.5% and 2% of the ASTs exceeding 50 U/L and 35 U/L, respectively). Conclusions Conservatively, $100 million could be saved annually in the US health care budget by selectively limiting AST testing in just the US outpatient environment. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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